Infectious Disease Compendium

Bell's palsy


A seventh nerve palsy.

Epidemiologic Risks

See microbiology.


Herpes simplex and Lyme, the former is the cause of recurrent disease. Acute HIV can present with Bells (PubMed).

Many are idiopathic, latin for who knows?

Empiric Therapy

Directed against the infecting organism; for Herpes acyclovir or valacyclovir for 5 days (PubMed) PLUS prednisone 40-60 mg a day, preferably within 3 days of onset, is recommended to speed resolution, although data to support is suboptimal (PubMed).

More recently (2007) acyclovir added NOTHING to 25 mg bid prednisolone x 10 days given within 72 hours of onset (PubMed). The Cochrane review, and who in their right mind would argue with them?) agrees (PubMed).


Lyme related Bell's usually has aseptic meningitis, painful neuropathy, more symptomatic systemically aka Bannworths syndrome.

Is associated, like many infections, with an increased risk of stroke (PubMed). What to do is unknown.


Last Update: 05/14/18.